So much for the entire field of behavior modification. Does that mean insurance companies now don't have to pay for psych care because it isn't evidence based? - Bill

Meta: But then again, depending on the state and the insurance company, they will also pay for such things such as "alternative medicine" i.e., Chiropractics, Acupuncture, herbal remedies, Homeopathy, etc..
I am certain that you know as well as I do that the mental health industry is itself currently in conflict over that very same topic, regarding the debate over which approach to mental theraputics is more valid; "Talk based" or "Bio-medical" based, and each side claims the other side has got it wrong and is invalid. (Though some invariably are fence sitters) So yes, I'd say the field of behavior modification is very much in question right now.
(Which as you also are aware, some currently illegal psychoactive compounds *could* possibly play a positive role if allowed by law.)

But then again, depending on the state and the insurance company, they will also pay for such things such as "alternative medicine" i.e., Chiropractics, Acupuncture, herbal remedies, Homeopathy, etc..

Actually for the most part, no.

This is tricky; bear with me.

Health insurance is a contractual affair. It's the only way that whole engine can run. The contract says they will pay for what is medically necessary.

FWIW, many psych services - especially for example Rx treatment of depression - have proven to be both evidence-based and medically necessary. It is state of the art - however flawed. But we both digress, right?

Because many "alternative therapies" have not yet proven to be effective or aren't yet proven to be medically necessary (due to thousands of articles in peer-reviewed literature), it is not possible to pay for many such therapies using the standard insurance contract. To do so opens the floodgates to pay for all kinds of quackery.

But meanwhile, the consumer wants what the consumer wants. If the consumer wants tailfins on the car, by golly the car maker ought either to build those tail fins or convince the consumer that he or she doesn't need them.

In order to deal with consumerism and the fact that some "alternative therapies" actually do some good in some circumstances, health insurance companies have found a way around the whole legal issue. They do it several ways.

1) The first and easiest way is for the insurance company to allow the consumer of health care services (evidence-based or not) to take advantage of the purchasing power of this big, 800 pound gorilla. Best Care insurance companies bargains with the acupuncture people (for example) on the "allowed amount" for a variety of services. They then go to the consumer and say "We have negotiated discount prices for you, and you can get them - out of pocket - with these providers of acupuncture services." Everyone is happy. The lawyers are happy. The insurance company is happy. The acupuncturist gets patients. The consumers are happier than they were before they had a discount.

2) A second way is to create the "alternative networks" (as above) and then give people a spending account. Joe Consumer gets a certain amount of money to spend each year in whatever way he sees fit. If he has extra left over at the end of the year, he gets to roll it over to the next year. If he spends too much, it starts coming out of pocket until they reach a "stop loss" level. Then the catastrophic policy kicks in.

So it isn't as simple as you say. But reasonable people can come up with workable solutions.

Because many "alternative therapies" have not yet proven to be effective or aren't yet proven to be medically necessary (due to thousands of articles in peer-reviewed literature), it is not possible to pay for many such therapies using the standard insurance contract. To do so opens the floodgates to pay for all kinds of quackery.

No argument there. However, (and perhaps you agree,)I would argue that the very nature of the concept "alternative medicine" (Hence the quotes) negates it from being medicine at all, and thus falls distinctly into the category of quackery.I see it this way: If "alternative medicine" was indeed "Medicine", then it would not be "alternative" at all. It would simply be called (AND THUSLY BE) only "medicine".

"Alternative medicine" is misleading because it automatically sets up a perceived separation of proper medical methodology, scientific procedure, and standards, of which there is none.It's akin to saying: I drink ""alternative water".Items that fall under the category of things one ingests which provide hydration are called "water", or items that contain water in part. There cannot be anything else which serves the same purpose.(and expect the patient to live that is.)Such is the same with medicine. It is either medicine or it is not. If it is not medicine, it is not "alternative medicine", but rather more correctly: "alternative TO medicine".Now I ask you: What person in their right mind would select something other than medicine to heal an ailment?Sounds like a no brainier, right?But yet "alternative medicine" i.e., "Quackery", is a multi-billion dollar a year business. It is akin to religion with some people, and one does not have to go very far to find evidence that "alternative medicine" has lead directly and indirectly to people's deaths, ruined health, or at best kept them from seeking proper treatment that they should have sought from the get go.(There's obviously more to this argument, but I need not go into detail at this time.)

So in summation:My position is that ALL "alternative medicine" is 100% B.S.. (Otherwise it would not be "alternative medicine" but simply "medicine"), and as such ALL "alternative medicine" practitioners are either direct or passive purveyors of quackery, disseminating the practice of public ignorance, and are liars, cheats, and a general menace to the public at large. You will find that the vast and overwhelming majority of public health practitioners and officials will agree with this viewpoint.(Although due to the asinine advancements in the political arena of "alternative medicine" practices, some physicians may take the road of beside manner to the patient and call "alternative medicine" "complimentary medicine".) Whatever. It still is not medicine.

Bill Glasheen wrote:

But meanwhile, the consumer wants what the consumer wants. If the consumer wants tailfins on the car, by golly the car maker ought either to build those tail fins or convince the consumer that he or she doesn't need them.

Meta: Right you are. But I feel that some people may be duped to feel that because "alternative medicine" is covered at least in part by their own insurance companies, that somehow it lends legitimacy to the practice itself.

Bill Glasheen wrote:

In order to deal with consumerism and the fact that some "alternative therapies" actually do some good in some circumstances, health insurance companies have found a way around the whole legal issue. They do it several ways.

Meta: I disagree here."alternative therapies" have NEVER done any good to anyone (EXCEPT STIMULATE THE PLACEBO EFFECT) and I would argue that any item which has had a measurable effect in health restoration was NOT attributed to the "alternative therapies" but rather was a legitimate therapy added as PART of the "alternative therapies".Again, if an item in "alternative therapy" worked as a legitimate therapy, it would be called a therapy, and not an "alternative to therapy."Example:Joe blow sprains his ankle.Knowing full well that "Real Doctors are money grubbing illness makers/Cash Mongers, He goes to an "alternative therapy" clinic and gets Acupressure, Acupuncture, Feng Shui lessons and a bottle of Sensei Metablades' herbal Chi colon cleanser. He is told to take the pills each day, get a massage each day with Acupressure and Acupuncture, He is told to re-arrange his room to better fit the "Chi" energy of his leg to set up a "Healing Environment", and lastly, he is told to stay off the ankle for two weeks. Well, Mr. Blow follows the treatment to the tee, and guess what? He's HEALED! There's the proof! Hallelujah! Now, which of these "alternative therapies" do you think gets the credit?It's P.T. Barnum Huckster-ism. Period.

Bill Glasheen wrote:

1) The first and easiest way is for the insurance company to allow the consumer of health care services (evidence-based or not) to take advantage of the purchasing power of this big, 800 pound gorilla. Best Care insurance companies bargains with the acupuncture people (for example) on the "allowed amount" for a variety of services. They then go to the consumer and say "We have negotiated discount prices for you, and you can get them - out of pocket - with these providers of acupuncture services." Everyone is happy. The lawyers are happy. The insurance company is happy. The acupuncturist gets patients. The consumers are happier than they were before they had a discount.

Meta: Right again, except the public gets duped, and the Charlatans get more credence to ply their bogus cures.

Bill Glasheen wrote:

2) A second way is to create the "alternative networks" (as above) and then give people a spending account. Joe Consumer gets a certain amount of money to spend each year in whatever way he sees fit. If he has extra left over at the end of the year, he gets to roll it over to the next year. If he spends too much, it starts coming out of pocket until they reach a "stop loss" level. Then the catastrophic policy kicks in.

Meta: Right again.[BTW, as a former Insurance agent, I can tell you that the corporations who have the most money on the planet are NOT the banks, credit unions, retail conglomerates or even technology firms. The richest companies in the world are Insurance companies. Don't believe me? Walk into the Corporate headquarters building lobby of of any major bank, then do the same with a major insurance company. The difference will be quite obvious.We used to have a saying in the business: Insurance companies own half the world's assets, and insure the other half.]

Bill Glasheen wrote:

So it isn't as simple as you say. But reasonable people can come up with workable solutions.

Meta: If that were the case, then why does the "alternative medicine" business continue to thrive and prosper year after year?

I understand your position on "alternate therapy." However I think you need to be careful here.

Many treatments or therapies are not prescribed because Western Medicine isn't (yet) trained to do so. Our old traditional model of healthcare was to treat people when they got sick. The very first insurance coverage was a Blue Cross plan that helped defray costs when you went to the hospital. Things have grown from there.

Managed Care was brought in allegedly to change the paradigm of healthcare. Initially it was all about healthcare financing, and customers truly got a bum rap on the treatment thing. It's all fine and well to shake the doctors and hospitals down so they get only what they deserve. RBRVS (resource-based relative value scale) had been a godsend, financed by the government for Medicare and advanced into traditional commercial insurance. It established a "worth" for every treatment, and then allowed whatever payer to apply a conversion unit to compute "allowed amount." That would be in dollars per relative value unit, or $/RVU. The battles with the hospitals has been a mixed affair. Both insurer and hospital chains got bigger so each could bargain hard for their share of the pie.

But in the end, we get to the point where we've squeezed all the fat out of the system there is on the finance end. And then guess what happens? Double-digit healthcare inflation returns once again.

True "manage care" is just now happening. This is where insurers or other entities work to produce information to physicians and hospitals so they understand how closely the treatment for the patients comply with evidence-based guidelines, and how efficient that care is delivered (for example, average cost of an episode of care of a certain disease type). The company I work for produces these various software packages, by the way.

And this is where it gets interesting, Meta. You see, guidelines from medical societies now endorse certain "nontraditional care" such as chiropractic for the palliative treatment of certain conditions such as acute low back pain.

But there's more.

Take yours truly. Dad and brother are going the traditional medical route of getting pharmaceutical treatment (one of two different types) to keep the plumbing running downstairs. Yours truly has chosen to take saw palmetto from early on. So far so good... I'm fifty-one and I take no medication. But I do take supplements (such as glucosamine for joints, omega 3, 6, an 9 fatty acids for joints and heart, saw palmetto for the prostate, etc.) to maintain my good health rather than treat poor health. Whether or not these supplements make it into "traditional" practice depends. You will now get cardiologists and primary care physicians for example telling patients to take fish oil (a source of omega 3 fatty acids) for the heart. But they don't necessarily buy into the rest of it.

And why? Profit. Whether you believe it or not, whether you like it or not, pharmaceutical companies drive a lot of care. You probably never knew you had "erectile dysfunction" until Bob Dole got on TV and alluded to being able to get a woodie while watching Brittany Spears videos. Now even 20-year-olds are going into physician offices asking for their Viagra. It makes them super lovers, you know...

Another med I haven't needed - yet.

Yea, a physician sure could tell you to take saw palmetto instead of getting on finasteride (Proscar). But there's no profit in it for the major drug companies, so you don't have the cute blondes with the bulbous butts and short skirts come smiling into the doctors' offices and offering free samples, free lunches, and some (ahem) product education. Believe it or not, I got this picture of an actress playing a drug rep from an article about the film in the British Medical Journal. She's easy on the eyes, no?

So how is something made with a slim profit margin going to be able to compete with the information overload making it to the physician? Right now, it doesn't very well. Meanwhile, saw palmetto is the standard of care in Europe. You see, Western Insurance generally pays for prescription medication. But it generally does NOT pay for OTC (over the counter) drugs and supplements. And whether or not something is to be dispensed by the pen of the doctor or available OTC can be somewhat arbitrary. The drug companies have learned the game though. If something comes off patent or made available OTC, they'll need to get something new coming through to maintain the high profit margins.

Go figure...

Another example would be stress. We all know stress is a cause of or at least exacerbates many illnesses (heart disease, GI problems, cancers, immune-based problems, dermatologic problems, psych problems, etc.) Well... Doesn't it make sense to reduce stress to lower healthcare utilization? It does if whatever it is you do to lower stress costs less on the net than the illnesses that happen while the member is on their watch. That's a tricky proposition, of course. Some illnesses have very short time courses and are worth the full court press to prevent problems. Asthma is a classic example, as is diabetes. Other illnesses such as cardiovascular disease take longer to unravel. It just isn't profitable for the insurer (or even the employer) to pay for such preventive care if it isn't going to pay off with the constant flux of employees and insurance members.

But to the extent that you can lower stress through massage therapy or gym memberships, why not? And if it makes them more productive at work, why wouldn't the employer buy into it? Some do, but usually through alternative routes. Again, they use their bargaining power to negotiate discounts for services and memberships.

Medicine is changing every day, Meta. What is "alternative" may become mainstream. But as you alluded to, it will be a fraction of what falls under the alternative umbrella today.

Would you believe 26% this year? Anthem really floored me with this recent increase. I had no doctor visits or prescription purchases in the last year. All I did was get a year older.

What bothers me about the underwriting process is that there is no credit given or detracted for lifestyle. Here I am, a non smoker, non drinker, non speeder who works out regularly and at over 50 passes the same fitness test 18 year old Marines take and that means zip.

Bill: Why is there not a 'wellness' component in the health care insurance underwriting process?

It gets down to 2 things, Rich.

1) The insurance contract always has been and may always be about "medical necessity." The demand for 3rd-party-paid treatment is much, much greater than the ability of any system to pay for it. If it's out of your pocket, you'd pick and choose wisely. But when someone else is footing the bill, you want Mercedes care.

So half of maintaining a lid on costs is about what the insurance policy will and will not pay for. Every insurance policy is tied to a contract, and the contract defines what will be paid for and how. And "medical necessity" is part of the language of the contract that puts a boundary around what will be paid for. Medical necessity usually is about a proven treatment for an existing or preventable illness. That gets defined by the peer-reviewed literature, and then by panels of physicians who determine what works and can be gotten at a reasonable cost (vis-a-vis what else can be done).

This is why you have the supplemental programs which essentially are discounts rather than true insurance. Gym membership will reduce stress and keep your weight down which staves off all kinds of age-related illnesses. But it's so far up the causality chain that it can stay outside the strict definition of "medical necessity."

California health plans are a little more forward thinking these days on what to include in discounts and what non-therapeutic services are made available. But then remember that California and Minnesota were the birth of the type of "managed care" that fell out of favor when there was a shortage of employees (latter 1990s) and strict limits on total salaries. Companies had to compete for these precious resources with before-tax benefits, like a less-restrictive health insurance product. Thus HMOs aren't quite what they used to be - if used at all.

Plus... It takes a lot of gym memberships or massages to prevent one heart attack. It's smarter for Anthem or some other insurance company to make discounts available to you rather than pay for it outright themselves. They provide the bargaining power, and you get a cheaper out-of-pocket deal.

I understand your position on "alternate therapy." However I think you need to be careful here.

Meta:Not at all. "Alternative Medicine is just not "medicine". Plain and simple.There's really no argument here. It just isn't medicine.Perhaps what you are thinking of are new medical techniques in development? The argument that : What used to be unacceptable medicine but now that science has "seen the light" is an often used as argument by Hucksters who are defending their quackery, and I might add, that any theory which can show proof to explain it is not "alternative science", but a theory. Legitimate research on up and coming medical technologies is *always* accepted until proven false as long as it is:

1. Based on solid scientific principal.2. Peer reviewed3. Is documented that is being pursued using quantifiable and repeatable outcomes or variables thereof, and it helps to pass double blind experiments as well.4. Stem from or are expansions of existing medical science therapies/practices.

Note: What is NOT seen in the medical field is a sudden, earth shattering "discovery" of ancient medical techniques, or "Sudden revolutionary methodology that changes the very core of the entire human medical paradigm", but rather what is seen has *always* been a progressive shift of medical technology based upon previous, existing, WORKING technologies. An example is the old saying: "I have only seen so far because I have stood on that shoulders of giants."

Sciences' growth is geometric, not spontaneous.

But I digress. Are there quacks in the legitimate medical field?Absolutely! But the system is designed to catch frauds sooner or later. None of the above can ever be said regarding "Alternative Medicines."Checks and balances DO exist.

Bill Glasheen wrote:

Many treatments or therapies are not prescribed because Western Medicine isn't (yet) trained to do so. Our old traditional model of healthcare was to treat people when they got sick.

This is another bit of often used "alternative medicine-religion" propaganda meme.I beg you, as a lay person to a Doctorite, to please re-read what you wrote, and perhaps think about what your process was and perhaps reflect on just how silly that sounds.Do you *honestly* feel that the "Western" Medical science model for healthcare was and is only about treating the body when sick? I think there would be a lot of people in the medical profession who would find that statement rather insulting, especially researchers and doctors past and present who have dedicated and sacrificed much, including their personal fortune and even lives to just an endeavor.

Question: What is the ultimate goal of medicine why does it exist?Answer: To prevent, and/or cure ALL human disease and aliments.

Bill Glasheen wrote:

Managed Care was brought in allegedly to change the paradigm of healthcare. Initially it was all about healthcare financing, and customers truly got a bum rap on the treatment thing. It's all fine and well to shake the doctors and hospitals down so they get only what they deserve. RBRVS (resource-based relative value scale) had been a godsend, financed by the government for Medicare and advanced into traditional commercial insurance. It established a "worth" for every treatment, and then allowed whatever payer to apply a conversion unit to compute "allowed amount." That would be in dollars per relative value unit, or $/RVU. The battles with the hospitals has been a mixed affair. Both insurer and hospital chains got bigger so each could bargain hard for their share of the pie.But in the end, we get to the point where we've squeezed all the fat out of the system there is on the finance end. And then guess what happens? Double-digit healthcare inflation returns once again.

Meta: Yes, there is a healthcare crisis in this country.(America)Yes, it's partly about greedy drug companies, unscrupulous insurance companies, lobbying, political favor, sex, lies, videotape and all the rest of man's evils and yes, even corrupt physicians.Heck, I've even been witness to a Doctor prescribing whatever "flavor of the month" drug ordered electronically from his wireless P.D.A. given for free by whatever pharmaceutical company happened to dissuade them that week. But this is important: That doesn't mean I should consider drinking psillium husks each day or ear candling or applied kinesiology, or herbs or "Eastern Medicine", or for that matter, sticking a corn-cob in my ear while standing on one leg chanting "Nam-Myoho-renge-kyo".

Our current health care system isn't perfect, and neither is science for that matter. But, just like the American form of government, It is the best and most effective thing we have going right now. Checks and balances, remember?

I fully believe more than anything, that the good doctors outweigh the bad, and logic, maturity, and doing the right thing for the patient's well being will always prevail.

Bill Glasheen wrote:

True "manage care" is just now happening. This is where insurers or other entities work to produce information to physicians and hospitals so they understand how closely the treatment for the patients comply with evidence-based guidelines, and how efficient that care is delivered (for example, average cost of an episode of care of a certain disease type). The company I work for produces these various software packages, by the way.

Meta: Funny you should mention that you work for a medical software company. So do I.

Bill Glasheen wrote:

And this is where it gets interesting, Meta. You see, guidelines from medical societies now endorse certain "nontraditional care" such as chiropractic for the palliative treatment of certain conditions such as acute low back pain.

They do so under state and government pressure I am certain: And why? Lobbyists. Nice huh!?But on the other issue, are'nt you perhaps confusing the quack practice of Chiropractics with SMT?

An estimated 80% of adults will experience a severe bout with back pain and dysfunction at some time in their life. There is substantial evidence that spinal manipulative therapy (SMT) has value in relieving back pain and improving the range of impaired spinal motion at least temporarily. Although SMT is probably no more effective than other modalities in the long term, it appears to offer faster relief in about one third of patients [2-4] Further, because SMT involves the laying on of hands, a technique widely employed throughout history by folk and faith healers, it enhances suggestibility and the placebo effect [5,6]. Many people like SMT because of the direct contact it involves and the subjective relief it brings. Charles DuVall, Sr., D.C., reports that SMT can become addictive [7].

Chiropractic is commonly thought to be synonymous with SMT. In reality, SMT's history goes back at least to Hippocrates (400 B.C.), while chiropractic's roots go back less than 100 years. Folk healers ("bonesetters") and early osteopaths used SMT as a panacea. Today SMT is employed by medical specialists (physiatrists, orthopedists, sports medicine practitioners), osteopathic physicians, physical therapists, and athletic trainers, as well as by chiropractors.

A survey of back-pain sufferers revealed that physiatrists are the most effective at treating back problems [8]. Physiatrists are medical doctors who specialize in rehabilitation. Formerly they were called doctors of physical medicine. But physiatrists are few in number and can be difficult to find. (They often practice in connection with Veterans Administration hospitals.) Some hospitals now have back treatment centers that emphasize strengthening weak stomach musculature (a major cause of back problems) and improving the flexibility of the back. Many of these centers offer SMT either by a physical therapist or a chiropractor.

Bill Glasheen wrote:

Take yours truly. Dad and brother are going the traditional medical route of getting pharmaceutical treatment (one of two different types) to keep the plumbing running downstairs. Yours truly has chosen to take saw palmetto from early on. So far so good... I'm fifty-one and I take no medication. But I do take supplements (such as glucosamine for joints, omega 3, 6, an 9 fatty acids for joints and heart, saw palmetto for the prostate, etc.) to maintain my good health rather than treat poor health. Whether or not these supplements make it into "traditional" practice depends. You will now get cardiologists and primary care physicians for example telling patients to take fish oil (a source of omega 3 fatty acids) for the heart. But they don't necessarily buy into the rest of it.

Note: My Dad had prostate cancer and opted to have it removed, which had left him incontinent as the risks involved depending on the cancer location, the surgery can also remove the muscles controlling the bladder. (Not good for a super active athletic guy like my dad. Luckily, he underwent a new procedure which literally gave him "robotic" control over his bladder. (The various jokes will continue forever) But most surprising was, that every doctor we talked to, and everything we read about men's prostate health pointed to an amazing fact: Prostate cancer is very slow to grow, and in fact, most men will die with at least some tiny portions of prostate cancer tumors. So it's not too high on my list. I still get checked, but THAT's no "fun day at the beach" either.

Bill Glasheen wrote:

Yea, a physician sure could tell you to take saw palmetto instead of getting on finasteride (Proscar). But there's no profit in it for the major drug companies.

Meta: It honestly frightens me that a Physician would advocate an unproven, unregulated supplement such as that. Whatever happened to "First, do no harm???"Are you CERTAIN your physician "recommended" it? Not just said something like: "It couldn't hurt.." or something like that? Scary stuff. (But just to be fair, so are half the new drugs that come out these days)Besides, indeed there IS money in it. From supplement suppliers, makers and distributors. It's a billion dollar a year business.

Bill Glasheen wrote:

But to the extent that you can lower stress through massage therapy or gym memberships, why not? And if it makes them more productive at work, why wouldn't the employer buy into it? Some do, but usually through alternative routes. Again, they use their bargaining power to negotiate discounts for services and memberships.

You are right, they SHOULD pay for these things. But the difference is that working out and massage are scientifically proven to increase health benefit. "Alternative medicine" is not.

Additionally, I'd like to provide to everyone, an excellent resource for those who wish to have a tool to begin the journey of debunking these frauds of "Alternitive Medicine" and delve into the world of rationale, logic, and sanity once again.

I'm wondering, however, if conventional medicine is much better at healing people than some of the quacks described in the articles you submitted.

I haven't taken a medicine of any kind in 40 years stronger than aspirin, but wouldn't go a month without a chiropractic "adjustment". Whether the result of a placebo effect or actual helpful manipulation of spine and joints, the monthly visit keeps me feeling fit as a 20 year old.

My yearly checkups by a medical doctor are also important and I do listen to him every year when he says: "Just keep doing whatever you are doing. See you next year!"

I've also tried acupuncture, with very limited success. (Helped me relax during a hectic & stressful camp, but didn't do anything for a stiff back/neck).

As long as the Chiropractor doesn't start telling you that "all of man's diseases are caused by bad alignment of your spine", that's fine and dandy..

~Sounds like SMT is what he's doing.
(Which is good stuff), but nothing "revolutionary" or "alternative" about it.

As far as medicine is concerned, I also indeed find that my doctors always seemed to be shocked when they do a physical on a me.

I recently went to a new doctor for a physical, and he said that he had to examine the results (esp. heart rate) twice because he said a man my age (36) should not be in such good shape, and he had thought he had made an error.
(I was as shocked as he was. I thought my level was just "normal". I left there feelin' pretty good about myself to say the least.)
So indeed, I'd attribute a life of practicing MA everyday as a better keeper of good health than any pill, diet, or food supplement.

P.s.
I had SMT performed on me when I was a teenager, and it helped with feeling better as well.
However I recommend long sessions of Shiatsu as the *O-Sama* of feelin' groovy...

Additionally, I'd like to provide to everyone, an excellent resource for those who wish to have a tool to begin the journey of debunking these frauds of "Alternitive Medicine" and delve into the world of rationale, logic, and sanity once again.

Quackwatch.org is run by Stephen Barrett who I believe is de-licensed and has been charged with racketeering and other legal problems- I think he was exposed as a fraud for claiming he was a "legal expert" although he had no formal legal training and it appears he has himself filed claims of defamation in court against over 40 people and lost every case. It appears that he is actually an MD, and worked as a psychiatrist for a while - and claimed he was a "board certified psychiatrist" - but in one of his court failures under oath was forced to admit he was not board certified - HE FAILED THE BOARD TEST....HA. Failing the board test is nowhere near as bad as then lying about it - failing the board test does not make Barrett a loser, it is going around and lying about it that does

I publish only a partial list of all his losses, humilations and personal embarassments. In a way he is a legal expert - he is an expert on how to lose in a court of law regarding health claims etc. I mean, he even lost a lawsuit of his in his own hometown. There used to be some guy at Ebudo.com that was a real Barrett brown-noser -some Judo guy.. Don something. The guy self-fashioned himself as some sort of consumer advocate of martial artists in the same vein as Barrett - considering Barrett's background it is probably a good comparison

There are indeed arguments against some alternative healing methods, but qouting Stephen Barrett as some source of logic and honesty is certainly tantamount to asserting oneself uneducated - believing in Barretts mess is to assert ones own dupability. It seems the guy is a zenith of duplicity, dishonesty and lack of integrity - in my humble opinion - but check it out yourself at these links (don't worry Metablade the links are free):

A survey of back-pain sufferers revealed that physiatrists are the most effective at treating back problems [8]. Physiatrists are medical doctors who specialize in rehabilitation. Formerly they were called doctors of physical medicine. .

Where do you get those statistics about the effectiveness of physiatry? Other peer reviewed studies logged in the national library of medicine indicate otherwise:

J Manipulative Physiol Ther. 2005 Oct;28( 8 ):555-63.

Cost-effectiveness of medical and chiropractic care for acute and chronic low back pain.

Haas M, Sharma R, Stano M.

OBJECTIVES: To identify relative provider costs, clinical outcomes, and patient satisfaction for the treatment of low back pain (LBP). METHODS: This was a practice-based, nonrandomized, comparative study of patients self-referring to 60 doctors of chiropractic and 111 medical doctors in 51 chiropractic and 14 general practice community clinics over a 2-year period. Patients were included if they were at least 18 years old, ambulatory, and had low back pain of mechanical origin (n = 2780). Outcomes were (standardized) office costs, office costs plus referral costs for office-based care and advanced imaging, pain, functional disability, patient satisfaction, physical health, and mental health evaluated at 3 and 12 months after the start of care. Multiple regression analysis was used to correct for baseline differences between provider types. RESULTS: Chiropractic office costs were higher for both acute and chronic patients (P < .01). When referrals were included, there were no significant differences in either group between provider types (P > .20). ****Acute and chronic chiropractic patients experienced better outcomes in pain, functional disability, and patient satisfaction (P < .01); clinically important differences in pain and disability improvement were found for chronic patients only.**** CONCLUSIONS: Chiropractic care appeared relatively cost-effective for the treatment of chronic LBP. Chiropractic and medical care performed comparably for acute patients. Practice-based clinical outcomes were consistent with systematic reviews of spinal manipulation efficacy: manipulation-based therapy is at least as good as and, in some cases, better than other therapeusis. This evidence can guide physicians, payers, and policy makers in evaluating chiropractic as a treatment option for low back pain.

This is one of numerous studies indicating that chiropractic provided better patient outcomess. Others were done by such notable think-tanks as the RAND corporation, and others include retrospectic analysis of workers compensation claims etc. I have looked at many of these over the last 20 years and never seen one indicating higher satisfaction with physiatry.

This is not to bad mouth physiatry. After I graduated chiropractic school roughly 20 years ago my roomate went to medical school and is now a physiatrist and combines both. I have a few more months to complete medical school and am in the process of interviewing for residency. Although my board scores are not the highest by any means I have been a top pick of many medical residencies BECAUSE of my 17+ years of chiropractic experience. Consider that most residencies get something like 500-800 applications and grant interviews to maybe 40 - 70 of them. I got granted interviews at every family medicine residency I applied to despite not haveing stellar board scores BECAUSE of my chiropractic experience (my grades in school were good but my board scores were not all that great - I know alot of people with scores in the 90's applied but got rejected in favor of me).

The medical programs are highly interested in my experience in chiropractic and look favorably on it. And its NOT because of pressure from lobbyists. In almost every medical student rotation I did I was asked to adjust the doctor and their patients : obestetrics, pediatrics, family medicine, general surgery, internal medicine , Physical medicine and rehab (physiatry) etc. On one of my letters of recommendation which came from a board certified MD in physical medicine and rehabilitation (physiatry) she wrote about how she learned from me - that is quite a compliment in a letter of recommendation for the mentor to say they learned from the student.

Please post a link to the study indicating better outcomes from physiatry alone - make sure the information is free and is crushing in its rationale to cause me to accept it without question.

I will be glad to post links to many more studies that prove chiropractic has a better outcome.

Legitimate research on up and coming medical technologies is *always* accepted until proven false as long as it is:

1. Based on solid scientific principal.2. Peer reviewed3. Is documented that is being pursued using quantifiable and repeatable outcomes or variables thereof, and it helps to pass double blind experiments as well.4. Stem from or are expansions of existing medical science therapies/practices.

The above study I published is peer reviewed and accepted by the national library of medicine. I challenge you to find one single peer reviewed study indicating chiropractic is "qauckery" as you say, or that it is less effective.

Many treatments or therapies are not prescribed because Western Medicine isn't (yet) trained to do so. Our old traditional model of healthcare was to treat people when they got sick.

This is another bit of often used "alternative medicine-religion" propaganda meme.I beg you, as a lay person to a Doctorite, to please re-read what you wrote, and perhaps think about what your process was and perhaps reflect on just how silly that sounds.Do you *honestly* feel that the "Western" Medical science model for healthcare was and is only about treating the body when sick? I think there would be a lot of people in the medical profession who would find that statement rather insulting, especially researchers and doctors past and present who have dedicated and sacrificed much, including their personal fortune and even lives to just an endeavor..

Bill is right that many "alternative methods" are simply not prescribed because medical doctors are not trained to do so. he is absolutely right. In 2 of the residency programs I was interviewed by, they had just recently put in chiropractic adjusting tables in order to train their doctors to do adjustments. As well, all of them offered an elective rotation in alternative treatments including acupuncture and chiropractic. There are medical schools here in the states that encourage learning alternative methods of healing. Doctors want to learn it, patients want it done - it is not because of political lobbying - some of it probably is due to money - 2 studies published in the Journal of the American Medical Association showed that more money is spent out of pocket to alternative treatments than is spent by insurance for PCP medical treatment - so I am sure some of the acceptance is driven just by money.

But that money that is being spent on alternative treatment speaks volumes about effectiveness - would people spend that much on something inneffective? No. Of course not - not for decade after bloody decade. Especially when alternative treatments get a fraction of the money spent on them that plain old medicine gets spent on advertising it - I mean something like every 3 page of advertisements in TIME magazine is about drugs. There are tons of commercials on TV about drugs - despite all the advertising people flock to chiropractors etc because it works.

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